What does simple uterine hyperplasia mean?

The exact cause of endometrial hyperplasia is not very clear at this stage, but long-term stimulation of estrogen is the most important cause. Women in menopause and girls in puberty have an imbalance in the function of the hypothalamic-pituitary-uterine-ovarian axis at a certain stage, which causes the uterine wall to be exposed to the effects of estrogen for a long time, resulting in hyperplasia. So, what does simple uterine hyperplasia mean?

It should be simple hyperplasia of the uterine wall, which refers to the imbalanced uterine bleeding caused by the uterine wall being affected by endocrine and the lack of ovulation. This phenomenon is due to the continuous action of estrogen on the uterine wall, and the body has no ovulation period and no estrogen antagonism, so the uterine wall undergoes varying degrees of hyperplasia changes.

Simple hyperplasia is the most common type of endometrial hyperplasia, which is mainly characterized by focal growth and development of the glandular ducts and interstitial space of the uterine wall. However, the cells are similar to the uterine wall in the normal proliferative period, without obvious atypia, and the probability of endometrial adenocarcinoma is only 1%. In other words, simple hyperplasia rarely worsens.

However, if it is menstrual disorder, prolonged bleeding, and pathology suggests simple hyperplasia, estrogen can be used to regulate the condition, and the menstrual period should be adjusted, and regular follow-up B-ultrasound should be performed to understand the condition of the endometrium.

Endometrial hyperplasia treatment

For the treatment of intestinal metaplasia of the uterine wall, the diagnosis must be established first and the cause must be identified. If it is accompanied by polycystic ovary, ovarian tumors, or other endocrine and neurological disorders, targeted treatment should be given. At the same time, patients diagnosed with intestinal metaplasia of the uterine wall should start medication treatment immediately, using medication or surgical treatment. The choice of plan should be determined based on the patient's age, requirements for pregnancy, and health status. For those under 40 years old, the disease tendency is low and drug treatment can be considered first. Young people who are looking forward to having a baby should first use medication treatment, because after medication treatment, about 30% of patients are still likely to become pregnant and give birth to a full-term baby. For women before and after menopause, the potential development of the disease is higher than that of young people, so hysterectomy is often performed immediately.

1. The standard of medication treatment is

Standard medication, long-term examination, regular testing, and timely pregnancy promotion. Medication type: Clomiphene, a blood pressure-induced ovulation drug, is taken once a day from the 5th to the 9th day of the cycle. If necessary, the medication period can be extended by 2 to 3 days. Blood estrogen drugs: They vary according to the degree of endometrial atypia. Mild intestinal metaplasia can be treated with intramuscular injection of corpus luteum copper, starting on the 18th or 20th day of the cycle, and taken for a total of 5 to 7 days. Patients with mild to moderate and moderate to severe intestinal metaplasia should use medroxyprogesterone continuously for a course of 3 months. After each course of treatment, a curettage or removal of uterine wall tissue for histological examination is performed. Depending on the response to the drug, the patient can choose to stop treatment or consider adjusting the dosage of the drug as appropriate. An IUD can also be placed in the uterine cavity.

2. Surgery

Curettage is not only an important diagnostic method, but also one of the treatment methods. Because some diseases can be eliminated through curettage. Patients aged 40 years and above with intestinal metaplasia of the uterine wall who are not pregnant can undergo hysterectomy once diagnosed. However, for patients with hypertension, diabetes, obesity or the elderly who have poor tolerance to surgery, drug treatment can be considered first under strict follow-up testing. Young patients who have failed to respond to medication, whose endometrial hyperplasia continues or worsens or is suspected to have developed into cancer, or whose vaginal bleeding cannot be controlled by curettage and medication, and who relapse after childbirth, can all consider surgical hysterectomy.